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AIM To investigate the effect of a low-FODMAP diet on irritable bowel syndrome(IBS)-like symptoms in patients with inflammatory bowel disease(IBD).METHODS This was a randomised controlled open-label trial of patients with IBD in remission or with mild-to-moderate disease and coexisting IBS-like symptoms(Rome III) randomly assigned to a Low-FODMAP diet(LFD) or a normal diet(ND) for 6 wk between June 2012 andDecember 2013. Patients completed the IBS symptom severity system(IBS-SSS) and short IBD quality of life questionnaire(SIBDQ) at weeks 0 and 6. The primary end-point was response rates(at least 50-point reduction) in IBS-SSS at week 6 between groups; secondary end-point was the impact on quality of life. RESULTS Eighty-nine patients, 67(75%) women, median age 40, range 20-70 years were randomised: 44 to LFD group and 45 to ND, from which 78 patients completed the study period and were included in the final analysis(37 LFD and 41 ND). There was a significantly larger proportion of responders in the LFD group(n = 30, 81%) than in the ND group(n = 19, 46%);(OR = 5.30; 95%CI: 1.81-15.55, P 0.01). At week 6, the LFD group showed a significantly lower median IBSSSS(median 115; inter-quartile range [IQR] 33-169) than ND group(median 170, IQR 91-288), P = 0.02. Furthermore, the LFD group had a significantly greater increase in SIBDQ(median 60, IQR 51-65) than the ND group(median 50, IQR 39-60), P 0.01.CONCLUSION In a prospective study, a low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission. 相似文献
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GSRS—A clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease 总被引:22,自引:0,他引:22
Jan Svedlund MD Ingemar Sjödin MD Gerhard Dotevall MD 《Digestive diseases and sciences》1988,33(2):129-134
An interview-based rating scale consisting of 15 items for assessment of gastrointestinal symptoms in irritable bowel syndrome and peptic ulcer disease has been developed. The interrater reliability was estimated by means of independent and simultaneous duplicate ratings by two raters in 20 cases and ranged from 0.86 to 1.00. The scale was easy to apply and proved to be useful in comparing the effectiveness of different modes of treatment in two clinical trials. 相似文献
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Learned illness behavior in patients with irritable bowel syndrome and peptic ulcer 总被引:12,自引:0,他引:12
Dr. William E. Whitehead PhD Carolyn Winget MA Al S. Fedoravicius PhD Susan Wooley PhD Barry Blackwell MD 《Digestive diseases and sciences》1982,27(3):202-208
Chronic illness behavior is defined by frequent visits to physicians, multiple somatic complaints, and disability disproportionate to physical findings. The prevalence of chronic illness behavior in people with irritable bowel syndrome and peptic ulcer was studied in a telephone survey of 832 people from metropolitan Cincinnati. People with irritable bowel syndrome (8% of the sample) were more likely than people with peptic ulcer (10% of the sample), and also more likely than the general population, to have multiple somatic complaints, to view their colds and flus as more serious than those of other people, and to consult a physician for minor illnesses. People with peptic ulcer were not different from the rest of the population in these regards. Chronic illness behavior appears to be learned; people who recalled being given gifts or special foods when they had a cold or flu as a child were more likely to exhibit chronic illness behavior and also more likely to have irritable bowel syndrome. These results suggest that social learning may contribute to the etiology of irritable bowel syndrome but not peptic ulcer.Supported in part by Research Scientist Development Award 7 K01 MH00133 from the National Institute of Mental Health and by grants MH 08018 and MH 14476. 相似文献
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Sonnenberg A 《Inflammatory bowel diseases》2007,13(6):763-768
BACKGROUND: The epidemiology of peptic ulcer and inflammatory bowel disease shows many similar patterns. The aim of the present study was to compare the geographic distribution of mortality from peptic ulcer with that from inflammatory bowel disease. METHODS: Mortality data from 27 countries between 1991 and 2004 were analyzed. The relationships between the geographic distributions of mortality from gastric ulcer, duodenal ulcer, Crohn's disease, and ulcerative colitis were compared using least-squares linear regression analyses. RESULTS: The study revealed a 20- to 30-fold variation in mortality from peptic ulcer and a 60-fold variation in mortality from inflammatory bowel disease among different countries. Mortality from peptic ulcer and inflammatory bowel disease tended to be more common in northern European countries and rare in most countries in Asia and South America. The similar variations of all 4 diseases resulted in the correlations among their geographic distributions being statistically significant. CONCLUSIONS: The similarities in the geographic distributions of gastric ulcer, duodenal ulcer, Crohn's disease, and ulcerative colitis indicate that all 4 diseases may share a common set of risk factors. 相似文献
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I L Taylor 《Clinics in gastroenterology》1984,13(2):355-382
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Coping strategies and interpersonal support in patients with irritable bowel syndrome and inflammatory bowel disease. 总被引:4,自引:0,他引:4
Michael P Jones Sarah Wessinger Michael D Crowell 《Clinical gastroenterology and hepatology》2006,4(4):474-481
BACKGROUND & AIMS: Coping strategies are used to manage conflict and illness and can have adaptive or maladaptive effects on health status. Perceived availability and quality of social support also influences health status. Coping strategies and social support have not been well studied in irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). To understand their role better, coping strategies, social support, and psychiatric distress were assessed in patients with IBS and IBD and in controls. METHODS: Participants completed the Ways of Coping Questionnaire, the Interpersonal Support Evaluation, Symptom Checklist-90-revised, IBS-Quality of Life (QOL), and IBD-QOL. Participants also completed the Toronto Alexithymia Scale and Somatosensory Amplification Scale. RESULTS: The study population included 55 controls, 74 IBS patients, and 48 IBD patients. The IBS and IBD patients had higher scores on measures of psychiatric distress, alexithymia, and somatosensory amplification than controls, but did not differ from one another. QOL scores did not differ between patients with IBS and IBD. Patients with IBS and IBD reported significantly less interpersonal support than controls. Controls identified planful problem solving as the dominant coping strategy whereas patients with IBS and IBD relied significantly less on planful problem solving and positive reappraisal and more on escape-avoidance strategies. CONCLUSIONS: Compared with controls, IBS and IBD patients had increased levels of psychiatric distress, a poorer QOL, less interpersonal support, and greater reliance on passive coping strategies. These data suggest that psychosocial disturbances are common in IBD and IBS and suggest that the observed differences reflect illness behavior rather than a disorder-specific process. 相似文献
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Mariette Bengtsson Klas Sjöberg Martina Candamio Annie Lerman Bodil Ohlsson 《European Journal of Internal Medicine》2013,24(3):266-272
BackgroundPrevious research has suggested an interaction between personality factors and inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). We therefore aimed to elucidate differences in psychological and coping functioning between patients with IBD and IBS, and to assess the relationship of disease activity with these functions.MethodsSeventy-four patients with IBD (mean age 43 ± 17 years, range 18–82 years) and 81 patients with IBS (mean age 37 ± 12 years, range 21–66 years) completed the questionnaires; Rosenberg Self-Esteem Scale, Toronto Alexithymia, Experiences in Close Relationships, and Sense of Coherence. Disease activity was evaluated either by the Harvey-Bradshaw index, the Simple Clinical Colitis Activity Index, or the Visual Analogue Scale for Irritable Bowel Syndrome.ResultsThe study revealed that patients with IBS had higher degree of anxiety in close relationships than patients with IBD (p = 0.003), and lower self-esteem (p = 0.001). No other statistical differences between the whole groups IBS and IBD or between subgroups were seen.ConclusionsThe fact that patients with IBS seem to have higher levels of anxiety in relationships and lower self-esteem could influence the way the patient deal with the disease and how the communication with health care professionals works out. A higher awareness of the importance of past negative life events should be taken into consideration. Whether the disease or the personal traits are the primary event should be addressed in future research. 相似文献
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Floch MH 《Current Treatment Options in Gastroenterology》2003,6(4):283-288
Opinion statement Probiotics are live, microbial food supplements that benefit the host animal by improving intestinal microbial balance. Their
major role in preventing and treating gastrointestinal disease appears to be from their effect on the immune process, protection
against abnormal invasive bacteria, and in the production of short-chain fatty acids from starch and non-starch polysaccharides.
Probiotic microorganisms are administered in food supplements and yogurts. They are also now sold in the form of capsules
and powders. There is great variation in the microorganisms in the various supplements. It is important to understand that
all probiotic products are different. Some contain a single organism and others contain multiple organisms. Therapeutic results
have been achieved with various probiotics in different diseases. In the treatment of inflammatory bowel diseases (IBD), success
has been reported with Escherichia coli Nissle strain in ulcerative colitis, and with a multiple organism product, VSL#3 (VSL Pharmaceuticals, Fort Lauderdale, FL), in
Crohn’s disease and pouchitis. Initial reports in irritable bowel syndrome (IBS) have resulted in encouraging results with
the use of E. coli Nissle strain, and recently with multiple organism probiotic supplements. However, caution must still apply to the use of probiotics
in IBD and IBS because the reports and the number of patients treated are limited. 相似文献
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Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction. 总被引:15,自引:0,他引:15 下载免费PDF全文
A standardised inventory of stressful life events and a bowel symptom questionnaire were administered at three month intervals for one year to 383 women who were unselected with respect to bowel symptoms. A NEO Personality Inventory was given initially to assess neuroticism. Subjects who satisfied restrictive diagnostic criteria for irritable bowel syndrome were compared with those who complained of abdominal pain plus altered bowel habits but who did not meet restrictive diagnostic criteria (functional bowel disorder) and with controls without bowel dysfunction. The irritable bowel group showed significantly higher levels of stress than the other two groups even when the confounding effects of neuroticism were statistically controlled for. Time lagged correlations showed that stress in one three month interval was significantly correlated with bowel symptoms in the subsequent three month interval for all groups. The slope of the regression line relating stress to bowel symptoms was significantly steeper for the irritable bowel group than for the other two groups at three and six months, suggesting that subjects with irritable bowel syndrome show a greater reactivity to stress. Stress scores were also significantly correlated with the number of disability days and the number of medical clinic visits for bowel symptoms. 相似文献
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Presenting symptoms and their duration may affect the time that elapses prior to definitive diagnosis of inflammatory bowel disease (IBD). This study was undertaken to determine the mean duration of presenting symptoms and diagnostic lag in children with IBD. The medical records of all patients less than 19 years of age diagnosed with IBD at the pediatric gastroenterology clinic of Children's Hospital of Wisconsin between 1990-1995 were reviewed. The age at diagnosis, gender, presenting symptoms and duration, disease location, and diagnostic lag were analyzed. There were 91 children (49 male) diagnosed with IBD. Crohn's disease (CD) was diagnosed in 58, ulcerative colitis (UC) in 24, and indeterminate colitis in 9. The mean ages at diagnosis were 11.4 years for CD, 9.7 years for UC, and 7.8 years for indeterminate colitis. The most frequent presenting symptoms were abdominal pain, diarrhea, hematochezia, and weight loss. The average lag in diagnosis of CD was 7.1 months, which varied by disease location: small intestine 10.5 months, ileocolonic 7.5 months, and colonic 6.4 months. The average lag in diagnosis was 6.7 months for UC and 14 months for indeterminate colitis. Children presenting with growth failure had the longest diagnostic lag. (a) The elapsed time between symptom onset and the diagnosis of CD has decreased. (b) The diagnostic lag in CD decreases with distal colonic involvement. (c) Following onset of symptoms UC was diagnosed only slightly more rapidly than CD. 相似文献
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BACKGROUND/AIM: Irritable bowel syndrome (IBS) affects about 15-20% of the population of the Western countries. Traditionally, IBS has been an exclusion diagnosis, but recently definitions have emerged from population-based research. The aim of this population-based study was to evaluate any association between gastrointestinal pathophysiology and IBS in subjects with symptoms of IBS compared to subjects with no abdominal complaints. METHODS: From a random sample of 2,656 participants, subjects with IBS (32) together with subjects without abdominal complaints (26), were invited for further evaluation. IBS was defined as more than weekly experience of abdominal pain and distension, and in addition either borborygmia or altering stool consistency. The diagnostic work-up consisted of gastroscopy, manometry and 23-hour pH and pressure recordings of the oesophagus, lactose tolerance test, barium enema, measurement of colonic transit time, and rectoscopy. RESULTS: Compared to the group without abdominal complaints significantly more subjects with IBS had spasms of the colon (OR = 10.2 (1.2-87.3)), and abnormal contractions of the oesophagus at manometry (OR = 9.1 (1.1-78.2)). Furthermore, there was a non-significant tendency towards spasms at 23-hour pH and pressure recordings (OR = 3.58 (0.4-35.2)), and more discomfort at lactose tolerance test (OR = 5.8 (0.6-51.3)) in persons with IBS compared to subjects without abdominal complaints. CONCLUSION: The results of this population-based study indicate that signs of gastrointestinal dysmotility and hyperperception are more prevalent in subjects with IBS than in subjects without abdominal complaints. 相似文献
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State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008 总被引:2,自引:0,他引:2
McFarland LV 《World journal of gastroenterology : WJG》2008,14(17):2625-2629
Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two of the leading causes of chronic intestinal conditions in the world. This issue of World Journal of Gastroenterology ( WJG) presents a series of papers from world experts who discuss the current knowledge and opinions on these important conditions. Although great strides have been made in the diagnosis, treatment and pathology of IBS and IBD; much has yet to be explained. The etiologies and risk factors of these multifactorial conditions remain elusive. Specific diagnostic biomarkers need to be developed and safer treatments developed. The burden of IBS and IBD on the healthcare system is felt with repeated medical care visits and high costs. IBS and IBD patients can account for 30%-50% of office visits at gastroenterology services/clinics. Over one million people have IBD in the United States, with 30000 new cases being diagnosed every year. One-quarter million people in the UK are afflicted with IBD. The cost of medical care in the United States for IBD is estimated to be $1.8 billion/year. 相似文献
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由于胃肠道微生物参与炎症性肠病(inflammatory bowel disease,IBD)的病理过程,而且最近研究表明微生物可能在肠易激综合征(irritable bowel syndrome,IBS)中扮演重要作用.本文重点关注益生菌在这两种疾病中的作用机制和疗效.胃肠道微生物的组成受多种因素调节,包括年龄、饮食和疾病状态.益生菌可能通过影响宿主的微生物菌群和提高黏膜的免疫调节作用发挥疗效.益生菌的口服耐受性较好.许多短期研究表明益生菌在IBS中有效,尽管只是在部分的特殊菌株和某些特定症状中有效.在IBD中,许多临床试验表明大量的益生菌在结肠袋炎和溃疡性结肠炎中有效,而对克罗恩病无明显疗效.显然,益生菌在IBS和IBD的治疗中能起到巨大的作用,但是,这些只是针对特殊的菌株.将来迫切需要进行高质量的临床研究和实验观察益菌对IBD和IBS的疗效. 相似文献
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Claudia I Reinders Max Herulf Tryggve Ljung Jakob Hollenberg Eddie Weitzberg Jon O Lundberg Per M Hellstr?m 《Clinical gastroenterology and hepatology》2005,3(8):777-783
BACKGROUND & AIMS: Differentiating patients with functional bowel disorders from those with inflammatory bowel disease (IBD) can be difficult. Rectal luminal levels of nitric oxide (NO) are greatly increased in IBD. To further evaluate this disease marker, we compared NO in patients with irritable bowel syndrome (IBS) with those found in patients with active IBD and in healthy control subjects. METHODS: Rectal NO was measured with chemiluminescence technique by using a tonometric balloon method in 28 healthy volunteers, 39 patients with IBS, 86 with IBD (Crohn's disease and ulcerative colitis), and 12 patients with collagenous colitis. In addition, NO was measured before and after a 4-week treatment period in patients with active ulcerative colitis and repeatedly during 2 weeks in healthy volunteers. RESULTS: NO was low in healthy control subjects (median, 45; 25th-75th percentile, 34-64 parts per billion [ppb]), and variations over time were small. In IBS patients NO was slightly increased (150, 53-200 ppb; P < .001), whereas patients with active IBD or collagenous colitis had greatly increased NO levels (3475, 575-8850 ppb, and 9950, 4475-19,750 ppb, respectively; P < .001). With a cutoff level of 250 ppb, NO had a sensitivity of 95% and a specificity of 91% in discriminating between active bowel inflammation and IBS. Rectal NO correlated with disease activity in IBD and collagenous colitis and decreased markedly in IBD patients responding to anti-inflammatory treatment. CONCLUSIONS: Rectal NO is a minimally invasive and rapid tool for discriminating between active bowel inflammation and IBS and a possibly useful add-on for monitoring patients with IBD. 相似文献
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The inflammation is an important component of the bowel wall structure. The amount of inflammation is gradually increased from normal state, to functional bowel disorders and to inflammatory bowel disease. Calprotectin is a recently established marker for intestinal inflammation. This paper surveys the present knowledge on fecal calprotectin testing as predictor of intestinal inflammation. We also show on a sample of patients that inflammation as tested with fecal calprotectin test may also be found, in lower degree, in irritable bowel syndrome. In inflammatory bowel disease, the calprotectin fecal test shows higher intensity values. 相似文献
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肠激综合征和炎症性肠病是两类不同的疾病,但近年来的基础研究和临床观察发现,两者存在相互联系.这为今后两种疾病的诊断、治疗、随访提出了新的要求.也为胃肠道功能性疾病的研究提出了新的思路.此文主要就肠易激综合征和炎症性肠病在发病机制和临床表现上的异同作一阐述. 相似文献
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胃肠激素与肠易激综合征 总被引:4,自引:0,他引:4
肠易激综合征 (Irritablebowelsyndrom ,IBS)是指大便习惯异常伴腹痛、腹胀、黏液便 ,而又缺乏可解释的形态学、生化学、影像学及内镜改变的临床综合征。据北京潘国宗教授等[1] 随机抽样调查发现北京市人群患病率按Manning标准和罗马标准分别为 7 2 6%和0 82 % ,其中 2 0 %患者频繁就诊过。因此研究IBS病理生理学基础 ,以期得到有效治疗方法 ,对于极大提高IBS病人的生活质量及避免大量医疗资源浪费是极其必要的。IBS的病因及发病机制尚未完全阐明 ,目前观点认为IBS患者的腹痛、运动功能及大便… 相似文献
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目的:研究粪钙卫蛋白在炎症性肠病(inflammatory bowel disease,IBD)与肠易激综合征(irritable bowel syndrome,IBS)鉴别诊断中的意义.方法:收集中国人民解放军北京军区总医院消化内镜中心接受肠镜检查患者的新鲜粪便标本共92例,其中溃疡性结肠炎(UC)23例、克罗恩病(CD)4例、IBS 55例、健康人20例.采用ELISA法半定量检测粪便中钙卫蛋白浓度.结果:健康人粪钙卫蛋白浓度为77.15±160.9μg/g,IBS患者为46.08±131.97 μg/g,IBD患者为851.34±522.19 μg/g.IBS患者和健康人粪钙卫蛋白浓度差异无显著差异(P>0.05); IBD与IBS和健康人粪钙卫蛋白水平有显著差异(P<0.001).以60 μg/g为临界值时鉴别IBD与IBS的敏感性86.7%,特异性为96.3%.结论:粪便钙卫蛋白含量检测作为一种非侵入性筛选试验,为临床鉴别IBD和IBS提供了手段. 相似文献